Kumar Vishal, Rai Ankit, Dhatt Sarvdeep Singh
Department of Orthopedics Surgery, PGIMER, Chandigarh, India.
J Orthop Case Rep. 2023 Jul;13(7):130-133. doi: 10.13107/jocr.2023.v13.i07.3782.
Growing rod construct is one of the most widely acknowledged treatment modalities for early-onset scoliosis around the world, but it is not without complications. Throughout the course of treatment, numerous planned and inadvertent surgical interventions are required, which increase the complexity of the treatment. We share our experience with case examples along with extensive literature search and review to get an insight and document the complications with growing rod treatment.
These cases underwent surgery with dual growing rod for thoracolumbar idiopathic scoliosis in the view of failed conservative treatment and progressive deformity. Superficial infection is in one case and recurrence of deformity was a common finding though correction of deformity and final fusion was achieved in the cases. Breakage of screws, autofusion of the spanned segments, and profuse bony growths over the implants are common finding to get. Fibrosis and scar tissue from the previous surgeries result in difficulty in the exposure and performing corrective osteotomy.
Growing rod surgery has high complication rates. Repeated surgical and anesthesia exposure pose a great risk to the body and immature skeleton of the young patient. Previous studies have put forth many possible course of action to lower down the complication rates but have met with variable results. A better implant design and surgical efficacy are needed to cut down the number of complications and surgical interventions in growing rod surgeries.
生长棒技术是全球范围内公认的治疗早发性脊柱侧凸最常用的方法之一，但并非没有并发症。在整个治疗过程中，需要进行大量有计划的和意外的手术干预，这增加了治疗的复杂性。我们通过病例实例分享经验，并进行广泛的文献检索和综述，以深入了解并记录生长棒治疗的并发症。
鉴于保守治疗失败且畸形进展，这些病例因胸腰段特发性脊柱侧凸接受了双生长棒手术。其中1例出现浅表感染，尽管病例中实现了畸形矫正和最终融合，但畸形复发是常见现象。螺钉断裂、跨越节段的自体融合以及植入物上大量骨生长是常见的情况。既往手术造成的纤维化和瘢痕组织导致暴露和进行矫正截骨困难。
生长棒手术并发症发生率高。反复的手术和麻醉暴露对年轻患者的身体和未成熟骨骼构成巨大风险。既往研究提出了许多降低并发症发生率的可能措施，但效果各异。需要更好的植入物设计和手术疗效，以减少生长棒手术的并发症数量和手术干预次数。
